Critical limb ischemia (CLI) is a severe blockage in the arteries which significantly reduces blood flow. CLI is a serious form of peripheral arterial disease and is caused by atherosclerosis, the hardening, and narrowing of the arteries due to the buildup of plaque. One of the treatment options for CLI is balloon angioplasty. For this procedure the surgeon can gain access through the femoral or the tibiopedal arteries using common surgical techniques such as the Seldinger technique. In these patients tibiopedal access is easier than femoral access since the amount of calcification of the arteries is higher on the femoral side.
Because the vessel is blocked by the buildup of plaque, it is necessary to carry out the balloon angioplasty in the arterial wall due to limited access available in the blocked arterial lumen. A wire guide is passed through the arterial wall and the balloon angioplasty is performed to open up the vessel wall. Due to access gained only from one side of the blockage, it is difficult to estimate the length of the balloon needed for the angioplasty of the arterial wall.
Currently, the angioplasty procedure is performed by gaining access into wall of the occluded artery and using a wire guide to move to the other end of the calcification. This is usually done by passing a wire guide or a stiff ended catheter through the arterial wall. Once access is gained though the calcification contrast injection is carried out to size the occlusion and then the balloon with the required size is used to carry out the angioplasty.
It would be beneficial to have a balloon catheter having a variable length balloon rather than having to select a balloon size after sizing the occlusion. It would be helpful if the length of the balloon could be varied during a procedure.